64排CT冠状动脉成像与心血管造影对壁冠状动脉诊断价值的对比

Comparition of 64-slice Computed tomographic Angiography and Coronary Angiography in Diagnosis for Myocardial Bridgemural Coronary Artery

目的比较64排螺旋CT冠状动脉成像(CTCA)与心血管造影(CAG)对壁冠状动脉的诊断价值。方法回顾性分析46例经由CTCA和CTA确诊的心肌桥-壁冠状动脉患者的图像,观察壁冠状动脉的发生部位、长度、埋藏深度及壁冠状动脉狭窄程度,同时分析壁冠状动脉狭窄程度与埋藏深度之间是否存在相关性。结果 46例患者中CTCA与CAG共同发现心肌桥62段,其中LAD心肌桥45段(占72.6%),LCX心肌桥7段(占11.3%),RCA心肌桥10段(占16.1%)。CTCA诊断壁冠状动脉平均长度为(6.8±2.5)mm,平均埋藏深度为(3.2±1.3)mm,平均狭窄程度(47.2±10.1%)。CAG诊断壁冠状动脉平均长度为(5.3±1.9)mm,平均埋藏深度为(2.9±1.4)mm),平均狭窄程度(57.3±11.2%)。两者对比差异有统计学意义(P<0.05)。壁冠状动脉狭窄程度与埋藏深度之间存在相关性,深埋型壁冠状动脉狭窄程度较表浅型壁冠状动脉狭窄程度更严重。结论 64排螺旋CT冠状动脉成像是诊断心肌桥-壁冠状动脉的有力检查方法,可为临床诊断及治疗提供重要参考价值。

Objective To compare the clinical value of 64-slice CT Angiography and Coro- nary Angiography for diagnosis of myocardial bridge -mural coronary artery. Methods The images of 46 patients with myocardial bridge-mural coronary artery confirmed by computed tomography coronary angiography（CTCA） and Coronary Angiography（CAG） were analyzed retrospectively. Observe the location, length, depth as well as the stenosis rate of mural coronary artery in CTCA and CAG images respectively. Find the relationships between the depth and the stenosis rate of mural coronary artery. Results Sixty-two myocardial bridges were/bund in the 46 patients, of which 45 cases were found in LAD （72. 6%）, 7 cases in LCX （11.3%） and 10 in RCA（16.1%）. The mural coronary artery were found with mean length （6.8 ± 2.5） ram, mean depth （3.2 ±1.3）mm, and mean stenosis rate of 47.2 ± 10. 1% in CTCA in compare with mean length（5.3 ± 1.9） mm, mean depth （2.9 ± 1.4） ram. and mean stenosis rate of 57.3± 11.2% in CAG. The difference between them has statistical significance （P 〈 0.05）. Conclusion 64-slice computed tomography angiography play an important role in diagnosis of myocardial bridge-mural coronary artery.